Aetiologie, Klinik und Prognose bei männlichen Rindern mit Harnröhrenverschluss

Aetiology, signs and prognosis of male cattle with urethral occlusion The objective of this prospective study was a detailed description of the clinical signs of cattle with urethral occlusion and to define prognostic indicators. Male cattle admitted to the clinic were included in the study if their history or initial clinical examination suggested urethral occlusion. A total of 126 cattle one month to two years old were enrolled. For the description of the clinical picture the relevant anamnestic information as well as the clinical and laboratory findings are described. Prognosis was evaluated on the basis of clinical, laboratory and post mortem findings, as well as on the subsequent course of survivors. The exact cause of the occlusion was determined by post mortem examination in non-survivors. Urethral occlusion can be diagnosed by physical examination. Failure to pass urine in animals with a distended urinary bladder or subcutaneous oedema or intraperitoneal urine accumulation are considered to be diagnostic. Not only the parameters of the special but also of the general physical examination turned out to be important in the evaluation of the stage of the disease and the detection of inflammatory processes. Initially a sawhorse stance, agitation and colic were prominent, whereas animals in the advanced stage became weak and recumbent; some of them did so after a transient period of apparent improvement of their general condition. For cattle with concomitant inflammatory processes an arched back with a distinctly depressed behaviour was significant. In addition these animals were mostly in a poor nutrional state and had a dull or shaggy haircoat. Among the findings of the special physical examination, inspection and/or palpation of the penis (evidence of a penis haematoma), the ventral abdomen (evidence of oedema), the abdomen (evidence of an intraperitoneal urine accumulation and/or peritonitis) and finally the evaluation of the umbilicus (evidence of ascending infections), bladder, and kidneys were found to be meaningful. Abdominocentesis was performed, if intraperitoneal urine accumulation and/or peritonitis was suspected. Depending on the age a rectal examination was often impossible. Deep palpation of the abdominal cavity couldn’t be performed in animals with a fully developed rumen, increased tension of the abdominal wall and those with ventral oedema or intraperitoneal urine accumulation. In these cases the diagnostic importance of ultrasonography in the examination of intraabdominal structures as well as the determination of increased inflammatory alteration of the intraabdominal fluid was evident. Among the laboratory findings, only azotaemia was significant, whereas other parameters didn’t show any consistent tendency with regard to the stage of disease or the involvement of inflammatory processes. A total 42 out of 60 animals with uncomplicated urethral occlusion were discharged. Out of 18 euthanized animals 11 were put to sleep because of extensive inflammatory alterations, five because micturition was not restored post operatively, and two because of other critical diseases. 41 of the patients showed intraperitoneal urine accumulation in varying extents with infections and accompanying irreparable inflammatory alterations present in 23 cases. Out of 18 cattle with non-infected intraperitoneal urine only seven could be cured, the others were put to sleep for other reasons. In two animals with slight oedema resorption took place within three days, whereas the massive infiltration of urine into the subcutis resulted in necrosis of the affected areas and was followed by gangrene in 13 cases. Except for two animals with an uracheal abscess and a bilateral pyelonephritis respectively all were discharged after an extended stay at the clinic. By contrast, four cattle with infected oedema developed cellulitis with distinct deterioration of their general condition and had to be destroyed. Six patients were put to sleep after the initial examination or during surgery. Therefore the further progression of the uric oedema couldn’t be evaluated. In five of these cases euthanasia was a consequence of urethral occlusion, in one case it was in consequence of another disease. Thus prognosis is mainly influenced by duration of illness as well as the involvement of inflammatory processes. Animals at the early stage of the disease, but also those with uric oedema in case of uncontaminated urine have a favourable prognosis. Prognosis is doubtful in animals with peritoneal accumulation of uninfected urine. It is nearly hopeless in the case of infiltration of infected urine into the subcutis (cellulitis) or in the abdominal cavity (peritonitis). Therefore, the presence of inflammatory processes should be ruled out as much as possible before surgical intervention is considered.

Level thesis:degree_level

thesis.doctoral

Grantor dc:publisher

Ludwig-Maximilians-Universität

Year

2003

Author dc:creator

• Gronau, Stefanie

Repository record source_url

https://edoc.ub.uni-muenchen.de/1259/

OAI identifier oai:identifier

oai:edoc.ub.uni-muenchen.de:1259